Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 00221 | Date 07/08/2018 |
| Token No | SM/18-19/230 07/08/2018 | Serial | 003 Last Visit: 07/08/2018 |
| Patient Name | Mrs. SOUMI BERA | Contact No | |
| Address | 19 RAMKRISHNA ROAD, MANNA PARA, CHATRA | Age | 10 Years,9 Months,27 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 26 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||